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Timing Retirement - Financial or state of mind -- what is your primary driver+plan?

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  • #16
    Originally posted by StarTrekDoc View Post
    Went to an orthopedic conference this week to see how you surgeons do things and was a great experience. I sat in a lunchtime discussion about 3 year retirement planning and surprised about how many in the room had no plans whatsoever.

    In fact, most cited no financial issues (poor orthopods clear $600k+ yearly easily per all the citations throughout the week) and primary issues from them retirement cited were: loss of power and loss of status/identity. That kind of surprised me. I didn't realize the need to be a 'king/queen' was a significant factor. There's always been the mantra 'have something to retire to' and I think it's harder for the surgeons to have this as they simply work longer hours by nature of typical career.

    Also very clearly private practices had no glidepath exit plans and reduction in time beyond a few hours was downright nonexistent (makes sense in high overhead private practices which they cited 30-50% typically).

    This especially was meaningful session as I had recently started my glidepath at 50 towards 60 retirement -- am I in the small minority of planning such where many looked simply to go from 110% to 0%?
    Interesting thread. The loss of identity is a factor for many I think. OB/GYN is a blend of surgery and office work. The sense of being captain of the ship is hard to replace in regular life. I do not even try. I do not want to be in charge of anything in my retirement. You do have to work at finding things to fill up your time. Retirement is not just financial planning. Retirement is all about slowing down because frankly you probably need to.

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    • #17
      Originally posted by Larry Ragman View Post

      I get the sense that yours is a common sentiment. But if so, something fundamental is broken in the leadership of our medical institutions if they cannot inspire enough loyalty for the employed professionals to even want to improve them.
      There is a sense of loyalty, but not to the institution. You may be loyal to a leader, but the leader builds a team. Your team may be loyal to you, but not to the institution. Your personal brand is what puts wind in the sails of the boat.

      Similar to an ace pitcher. You depend on many, but when the next batter comes up, it’s all on you. Ortho needs to be able to go on game day. Only so many spots on a roster, do you want to be a spot starter or a reliever? Yes there is ego, but the institution will move on, be it employed or private. Difficult to be an Ace pitcher as a part timer.
      I disagree that an medical institution leadership is failing by not focusing on loyalty.

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      • #18
        What is interesting is that there is a movement to FIRE and escape from employment.

        however, when you look at high achievers, those who are able to define the terms of their work load, retirement is later or never. I am thinking of entrepreneurs, cEOs (who may retire but continue on multiple boards, paid and unpaid) professors, those in creative professions. Certainly, if somebody can do a job on a project basis rather than punching a clock, one can work intermittently as long as they feel fulfilled. It’s hard to do in medicine, especially surgery, where you need a certain amount of volume to be current and maintain skills.

        Many of my happier older patients are still working, often just to be busy. There’s a certain physical and psychic and benefit to being productive. It does not have to be work, but it could be.

        it all about what to retire to…

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        • #19
          Originally posted by Hatton View Post

          Interesting thread. The loss of identity is a factor for many I think. OB/GYN is a blend of surgery and office work. The sense of being captain of the ship is hard to replace in regular life. I do not even try. I do not want to be in charge of anything in my retirement. You do have to work at finding things to fill up your time. Retirement is not just financial planning. Retirement is all about slowing down because frankly you probably need to.
          This x 100.

          I was mentally (and financially) ready to retire from the practice of radiology, but I was not mentally ready to retire from work. The challenge was to find something to do to fill my time. I landed in a full time administrative job working for a large health insurance co. I would have liked something part time and perhaps something less medical, but I can hang out here for a few years while I figure out what is next.

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          • #20
            Originally posted by VagabondMD View Post

            This x 100.

            I was mentally (and financially) ready to retire from the practice of radiology, but I was not mentally ready to retire from work. The challenge was to find something to do to fill my time. I landed in a full time administrative job working for a large health insurance co. I would have liked something part time and perhaps something less medical, but I can hang out here for a few years while I figure out what is next.
            Our local schools are desperate for substitutes and bus drivers. I know a few retired folk who do it just as much for something to do and a way to help the community in need.

            Some people would see it as a form of torture but others may enjoy it.

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            • #21
              Originally posted by Turf Doc View Post
              Maybe pick up a new hobby like this doc?

              I'm not sure what to think of an older physician who feels the need to wear knee pads and wrist guards for skating but not a helmet. D- on the bucket hat.

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              • #22
                I think the FIRE mindset is still relatively new, especially in medicine since we start off with such a high debt burden. It's gaining traction but still out of reach for many.

                Then it gets divided to the shift based and procedural based specialties. Shift based is a lot easier for multiple reasons. Then the procedural based specialties get further broken down into the ones that can just do clinic vs essentially needing an OR to provide significant value. ENT, Urology, OB/GYN can still provide great value in the clinic alone. Specialties like General, Ortho have a lot harder time without an OR.

                I'm still working part timeish now, taking 1 week of ER call a month for a rural hospital in my old hospital system but plan on stopping after this year. This was my slow transition out of medicine and I still trade my options essentially full time so I still have something to retire to and keep me occupied.

                I also think the older generation have the identity issues. All they know is medicine and surgery, so they just keep going. Not sure if it's more mentally or financially driven, but the older surgeons seem more likely to work forever.

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                • #23
                  Originally posted by Turf Doc View Post
                  Maybe pick up a new hobby like this doc?

                  Really interesting guy. Maybe WCI can get him on podcast?

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                  • #24
                    Originally posted by Larry Ragman View Post

                    I get the sense that yours is a common sentiment. But if so, something fundamental is broken in the leadership of our medical institutions if they cannot inspire enough loyalty for the employed professionals to even want to improve them.
                    I think a big issue is that most leaders of our medical institutions really don't have any idea how medicine works on a day to day basis. Physicians as a whole aren't good business people like administrators aren't good at medicine. There's a big gap between the two. Plus, the government also doesn't help with many of its ridiculous rules and regulations.

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                    • #25
                      Originally posted by Tim View Post

                      There is a sense of loyalty, but not to the institution. You may be loyal to a leader, but the leader builds a team. Your team may be loyal to you, but not to the institution. Your personal brand is what puts wind in the sails of the boat.

                      Similar to an ace pitcher. You depend on many, but when the next batter comes up, it’s all on you. Ortho needs to be able to go on game day. Only so many spots on a roster, do you want to be a spot starter or a reliever? Yes there is ego, but the institution will move on, be it employed or private. Difficult to be an Ace pitcher as a part timer.
                      I disagree that an medical institution leadership is failing by not focusing on loyalty.
                      Interesting, but I do not think I was clear. Management doesn't have to focus on loyalty. They need to bridge the gap between business/insurance interests and treating their primary resource, medical professionals, right. Both sides need to be part of the team trying to provide care. Building that team requires leadership in the true sense of the word, both at individual institutions and for the profession. Loyalty is a by-product. Think back to NASA and Apollo. The apocryphal janitor is able to say his team is putting a man on the moon.

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                      • #26
                        I was mentally (and financially) ready to retire from the practice of radiology, but I was not mentally ready to retire from work. The challenge was to find something to do to fill my time. I landed in a full time administrative job working for a large health insurance co. I would have liked something part time and perhaps something less medical, but I can hang out here for a few years while I figure out what is next.

                        I have similar feelings being ready financially and mentally to retire from medicine. But I don't know what I would do with so much free time. I was thinking about a second career, but I always think, why would I want to do something else and earn less than I do now. I know life is not always about the money, but really I don't work that hard now.

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                        • #27
                          Most older docs I know, surgery or not, did slow down over time unless there was a health issue that required them to stop cold turkey. But usually this would start well after their 60's. They would cut back on procedures, surgery, work days, etc. Some may keep up this pace until their last days because they enjoy it, have nothing else to do or to socialize with patients. The rest retire completely and do whatever. Mostly private practice but some employed too (probably due to my sample size), but it seems the PP guys have a much longer and gentler glidepath. Some older PP guys would sell their practice to the hospital and work for them for a few years before retiring too.

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                          • #28
                            Company/Health System priorities -- Mission Statement -- IPS: this is the driving force IMHO. When I first started I really thought the Mission Statement was really a bunch of mumbo-jumbo. As I get more salt+pepper and lessons learned, these guiding principles do really reflect the core nature of the 'how and why' of the entity. Of course, they have to be truthful and the folk guiding the ship following said statement; if done right, the words would reflect the stripes of company.

                            That said, even in academia where the mission statement is quite lofty, health care is a $3.5Trillion (18% GDP) beast and the mighty dollar drives the majority of the conversation and driven more and more by MBAs than physicians. This is where burnout and dissatisfaction happens when 'the system' starts missing alignment with 'the team'.

                            It's interesting to see how many folk near retirement move over to the 'dark side' of admin or insurance/industry. while I've taken the opposite and moved away from admin responsibilities and made clear to system that they will have to pay me clinical equivalent+headache --- they haven't asked me to do more (go figure).

                            cards67 - this is what I'm interested to see with many of us financially ready in their 50-60s to glidepath down toward retirement and retiring into something active nonmedical -- do actually DO THIS. How many are good with being the school volunteer for x activities or local activist for y issue or 2nd business career in winery/bike shop/comic book store or slomo v2.0. I have a side business, lego, and disney addictions along with a travel bucket list to fill in plenty of time.

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                            • #29
                              Originally posted by CordMcNally View Post

                              I'm not sure what to think of an older physician who feels the need to wear knee pads and wrist guards for skating but not a helmet. D- on the bucket hat.
                              Maybe he read this
                              https://www.nejm.org/doi/full/10.105...99611283352202

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                              • #30
                                Originally posted by Notsobad View Post
                                Says 'the effectiveness of helmets could not be assessed' but any elderly person on anything with wheels would benefit from a helmet.

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